0001127602-16-065149.txt : 20161024 0001127602-16-065149.hdr.sgml : 20161024 20161024163344 ACCESSION NUMBER: 0001127602-16-065149 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161021 FILED AS OF DATE: 20161024 DATE AS OF CHANGE: 20161024 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ERIE INDEMNITY CO CENTRAL INDEX KEY: 0000922621 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411] IRS NUMBER: 250466020 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 ERIE INSURANCE PL CITY: ERIE STATE: PA ZIP: 16530 BUSINESS PHONE: 8148702000 MAIL ADDRESS: STREET 1: 100 ERIE INSURANCE PLACE CITY: ERIE STATE: PA ZIP: 16530 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Vorsheck Elizabeth A CENTRAL INDEX KEY: 0001396850 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24000 FILM NUMBER: 161948290 MAIL ADDRESS: STREET 1: 6252 COMMERCIAL WAY PMB 140 CITY: BROOKSVILLE STATE: FL ZIP: 34613 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2016-10-21 0000922621 ERIE INDEMNITY CO ERIE 0001396850 Vorsheck Elizabeth A 6252 COMMERCIAL WAY PMB 140 BROOKSVILLE FL 34613 1 1 Class A Common Stock 69516 D Class A Common Stock 324300 I By Audrey C. Hirt 1989/1990 Income Trust For E. Vorsheck Class A Common Stock 500000 I By Elizabeth A. Vorsheck 2009 10-year GRAT Class A Common Stock 162533 I By Elizabeth Vorsheck Trustee Elizabeth Vorsheck Revocable Trust U/A DTD 05/03/99 Class A Common Stock 372565 I By Frank William Hirt 1989/1990 Trust For E. Vorsheck Class A Common Stock 3000000 I VEIC Limited Partnership Directors' Deferred Compensation Phantom Units 0 2016-10-21 4 A 0 64.431 0 A Class A Common Stock 64.431 8579.293 D Class B Common Stock 0 Class A Common Stock 2808000 1170 I Contingent Beneficiary & Trustee, Trust Class B Common Stock 0 Class A Common Stock 2808000 1170 I Contingent Beneficiary & Trustee,Trust Conversion price is not applicable to shares granted under the Erie Indemnity Company Deferred Compensation Plan for Outside Directors (the "Plan"). Acquired pursuant to dividend reinvestment provisions of the Plan. The number of Phantom Units credited to the account of the reporting person was determined in accordance with the Plan, based on the closing price of the Class A Common Stock on October 20, 2016. The shares subject to this reporting are phantom Share Credits which are periodically credited to the accounts of certain Directors of Erie Indemnity Company pursuant to the Plan. These Share Credits are actually paid to the reporting individual in shares of Erie Indemnity Company Class A Common Stock when their service as a Director of Erie Indemnity Company ends. There is no exercisable date for these securities. The shares subject to this reporting are phantom Share Credits which are periodically credited to the accounts of certain Directors of Erie Indemnity Company pursuant to the Plan. These Share Credits are actually paid to the reporting individual in shares of Erie Indemnity Company Class A Common Stock when their service as a Director of Erie Indemnity Company ends. There is no expiration date for these securities. Pursuant to the Articles of Incorporation of the Company, as amended, shares of Class B Common Stock (voting) of Erie Indemnity Company are convertible at any time to shares of Class A Common Stock (non-voting) at a conversion rate of 2,400 shares of Class A Stock for each share of Class B Stock. There are no exercise or expiration dates associated with this conversion feature and no specific exercise price when a Class B share is converted into Class A shares. Chandra M. Burns, Power of Attorney 2016-10-24